| NPI | 1790133015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 14282) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 14282) |
| 101YP2500X Counselor, Professional (Licence: GA 3497) | |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2019-06-06 |